[Primary mediastinal sarcomas]

Application of Artificial Intelligence in the Diagnosis, Treatment, and Prognostic Evaluation of Mediastinal Malignant Tumors

Artificial intelligence (AI), also known as machine intelligence, is widely utilized in the medical field, promoting medical advances. Malignant tumors are the critical focus of medical research and improvement of clinical diagnosis and treatment. Mediastinal malignancy is an important tumor that attracts increasing attention today due to the difficulties in treatment. Combined with artificial intelligence, challenges from drug discovery to survival improvement are constantly being overcome. This article reviews the progress of the use of AI in the diagnosis, treatment, and prognostic prospects of mediastinal malignant tumors based on current literature findings.

Low-grade fibromyxoid sarcoma arising in the mediastinum: Case report and review of the literature

Low-grade fibromyxoid sarcoma (LGFMS) is a rare tumor characterized by bland histological features and aggressive clinical course, it is a distinctive variant of fibrosarcoma with high metastasizing potential and sometimes a long interval between tumor presentation and metastasis, the most common anatomic locations of occurrence are the lower extremities, thorax, inguinal area, and upper limbs, Here, we present the case of a 29-year-old patient with a deceptively benign-appearing mass arising in the mediastinum that had been discovered on computed tomography, a biopsy under cervicotomy was performed and histopathological examination revealed low-grade fibromyxoid sarcoma. In conclusion, LGFMS can arise in the mediastinum, and physicians should consider this entity as a differential diagnosis in the presence of such mass.

Treatment Approaches and Outcomes for Primary Mediastinal Sarcoma: Analysis of 976 Patients

BACKGROUND

Primary mediastinal sarcomas are rare and deadly. Our objective was to describe the clinicopathological features, treatment strategies, and overall survival outcomes for a contemporary cohort of patients diagnosed with primary mediastinal sarcoma in the United States.

METHODS

We queried the National Cancer Database for cases of mediastinal sarcoma diagnosed from 2004 to 2012. Five-year overall survival (OS) was examined using the Kaplan-Meier method. Differences in OS were assessed using log-rank analysis and Cox proportional hazards regression.

RESULTS

The mean age of diagnosis was 53 years (range, 0 to 90) with a male predominance (59.2%). The most common histological subtype was hemangiosarcoma (27.1%). Fewer than half of patients underwent surgery (48.9%), and 19.7% of patients had no treatment. For all patients, OS was 14.8%. The best unadjusted OS was seen in patients treated with surgery and radiation (40.1%); untreated patients had the worst unadjusted OS (4.2%). Of those who underwent surgery (n = 477, 48.9%), OS was significantly better for those who achieved an R0 resection (30.1% versus 18.9%; p = 0.002). In multivariable analysis, surgery combined with radiation therapy was again associated with the best survival (HR, 0.24; 95% CI, 0.16 to 0.36). Other factors associated with improved OS included younger age, fewer comorbidities, and leiomyosarcoma histology. Worse OS was associated with poorly differentiated or undifferentiated grade, metastases, treatment in the New England region, and having Medicaid or no insurance. Sex and tumor size had no effect on OS.

CONCLUSIONS

The 5-year OS for primary mediastinal sarcoma is poor. Surgical resection can be successful and should be considered whenever possible.

Mesenchymal tumours of the mediastinum--part II

This is the second part of a two-part review on soft tissue tumours which may be encountered in the mediastinum. This review is based on the 2013 WHO classification of soft tissue tumours and the 2015 WHO classification of tumours of the lung, pleura, thymus and heart and provides an updated overview of mesenchymal tumours that have been reported in the mediastinum.

Ultrasonography, X-ray and CT imaging findings of a giant pericardial lipoma: Imaging diagnosis and review of the literature

Pericardial lipomas are rare and mostly asymptomatic tumors, which are usually detected incidentally during physical examination. The present study describes a case of giant pericardial lipoma that was diagnosed by surgical pathology. The study also describe the X-ray, magnetic resonance imaging, and the distinguish of the pericardial lipomas. The study also describes the ultrasonography, X-ray, computed tomography and magnetic resonance imaging findings of the tumor, and a review of the literature of cardiac lipoma, to help increase awareness of the tumor and selection of the correct imaging method for diagnosis.